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    21 October 2010, Volume 31 Issue 5
    呼吸病学专题
    Evaluation of Role of Astograph Methacholine Provocation Testin Diagnosis of Bronchial Asthma
    ZHANG En-hua;PAN Na;PENG Jing-jing;HUANG Ke-wu
    2010, 31(5):  531-535. 
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    Objective To evaluate the role of Astograph methacholine provocation test in diagnosis of bronchial asthma. Methods Totally 56 asthmatics patients were recruited and 90 non-asthmatics patients was enrolled as control. All participants were asked to take Astograph methacholine provocation test. Spirometry and pulse oscillation measurements were conducted, and their breath resistance and spirometry parameters before and after the challenge were recorded and analyzed. Results 1) The provocative test of 52 participants out of 56 asthmatic patients were positive, the positive rate was 92.9%. In the 90 cases of non-asthmatic patients, the provocative test of 42 patients were negative, the negative rate was 46.7%; There was a significant difference in breath resistance at 5Hz(R5), breath resistance at 35 Hz(R35), Peak expiratory flow(PEF), forced expiratory volume in 1 second(FEV1), forced vital capacity(FVC)(before and after the challenge), accumulated dose minimum induction(Dmin) between asthma group and non-asthmatic group(P<0.05); 2) The sensitivity, specificity, and accuracy of Dmin ≤6 Unit as cutoff for the diagnosis of asthma were 71.2% and 74.4% and 53.0%. The specificity of diagnosis increased significantly when Dmin combined with FEV1 decreased by 20% as positive standard. Conclusion Astograph methacholine provocation test had good specificity and sensitivity in the diagnosis of bronchial asthma especially when the Dmin≤6 Unit as the cutoff value. Furthermore, its specificity was improved when FEV1 was measured at the same time.
    Effects of Pentoxifylline on the Inflammatory Reaction in Experimental Obstructive Emphysema Rat Models
    CHEN Yang-yu;ZHANG Hong-yu;PANG Bao-sen;LI Yuan-hong
    2010, 31(5):  536-539. 
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    Objective Pentoxifylline(PTX) has been shown to suppress the cytokine production. This study aimed to investigate the effects of PTX on the production of proinflammatory cytokines, and correlation between the inflammation and obstructive emphysema in rat models. Methods Thirty-six Wistar rats were randomly divided into 3 groups. ① Normal group(n=12), rats were bred in canonical environment. ② Obstructive emphysema model groupⅠ(n=12), 3 mg/kg lipopolysaccharide was injected intravenously once every two weeks and the rats were exposed to 5% of cigarette smoke,0.5 h/each time, twice daily for 45 days. ③ Model group Ⅱ(n=12), they were the same as those of obstructive emphysema model groupⅠ, but 15 mg/kg pentoxifylline was injected intraperitoneally once daily at the 1 to 30 days. Results The pathologic change of airway and lung tissues of obstructive emphysema models were similar to those of COPD patients. Pulmonary function of the obstructive emphysema model group(FEV0.2/FVC%) were significantly worse than those of normal group and the model groupⅡ(P<0.01). The level of IL-8, IL-10, TNF-α was significantly different from those of the obstructive emphysema model group Ⅰ and model group Ⅱ(P<0.01). Conclusion Experimental obstructive emphysema rat models were successfully established by passive cigarette smoking and injection of lipopolysaccharide. The treatment with PTX could make the pathologic change of airway and lung tissues milder than those of obstructive emphysema model group, and inhibit the production of these proinflammatory cytokines, PTX may reduce damage to the lung in obstructive emphysema.
    Evaluation of the Safety of Bronchoscopy under Intravenous Anesthesia with Propofol Combined with Sulfentanyl in Elderly Patients with Pulmonary Dysfunction
    JIAO Xia;ZHANG Li-ming;YANG Ting;MA Xin;MAO Wen-ping;HANG Yan;XUE Yi;LI Jie
    2010, 31(5):  540-543. 
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    Objective To evaluate the safety of bronchoscopy under intravenous anesthesia with propofol combined with sulfentanyl(painless bronchoscopy) in elderly patients with pulmonary dysfunction. Methods Seventy-six elderly patients who undergoing painless bronchoscopy were enrolled and divided into two groups according to pulmonary function. Group A had 42 cases with normal or slight dysfunction and group B had 34 cases with significant hypofunction. Their blood pressure, heart rate(HR), respiration rate(RR) and oxygen saturation by pulse oxymetry(SpO2) were checked before giving the anaesthetic, before the examination under anesthesia, during the examination, completely conscious from anesthesia and 24 h after the examination. The adverse reaction and analepsia time were recoded. Oxygen was given by nasal catheter during the examination. Results After giving anaesthetic, the systolic pressure(SP), diastolic pressure(DP) and HR tended to go down significantly in patients of group A and group B compared with those recorded before giving anaesthetic. Only group B showed significance in RR and SpO2 before the examination and after giving anaesthetic. For RR and SpO2 there were no significant difference between the two groups during the examination and after becoming completely conscious. There were no significant difference in HR, SP, DP, RR and SpO2 before vs. 24 h after the examination. The time of palinesthesia and adverse reaction were similar in both groups. Conclusion Under careful monitoring it is relatively safe to perform painless bronchoscopy for elderly patients with pulmonary dysfunction. Attention should be paid to respiratory depression and respiratory management should be strengthened early.
    Effects of Sepsis on the Expression of Glut-1 and Glut-4 mRNA in Rat Diaphragm
    CHANG Yi;NIE Xiu-hong;CAI Yan-ning;CAO Ruo-jin;FENG Ming
    2010, 31(5):  544-547. 
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    Objective To investigate the expression of Glut-1 and Glut-4 mRNA in septic rat diaphragmatic muscle. Methods A rat model of septic and control model was established, and the expression of Glut-1 and Glut-4 mRNA in diaphragmatic muscle of SD rats were analyzed by RT-PCR. Results The expression of Glut-1 and Glut-4 mRNA showed an increasing trend with aging and sepsis. Conclusion The imbalance of diaphragmatic carbohydrate metabolism in sepsis plays a vitally important role in sepsis in respiratory dysfunction , especially, the Glut-1 and Glut-4 mRNA expressions in rat diaphragm are altered with age while sepsis effects on Glut-1 and Glut-4 mRNA expressions are age dependent.
    Deep Venous Thrombosis Related with Central Venous Catheterand Its Medical Prevention
    YE Yan-ping;DUAN Jun;FANG Hua;CAO Cheng-qi;YANG Qi;CHEN Jin
    2010, 31(5):  548-551. 
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    Objective To observe the probability of deep venous thrombosis related with central venous catheter(CVC-related DVT), to explore the efficacy and safety of prophylactic anticoagulant therapy for the prevention of CVC-related DVT.
    Methods Totally 112 patients who had received CVC insertion were randomly assigned into two groups, the patients in the therapy group were given subcutaneous low-molecular-weight-heparin 0.6 mL once a day and those in the control group were not given any anticoagulant. Color Doppler ultrasound examination was performed for each patient at the end of the first, the second, the forth and the sixth week respectively after CVC insertion to confirm the development of CVC-related DVT. Meanwhile, bleeding complications were observed.
    Results The probability of CVC-related DVT in the control group and the therapy group were 12.5%(7/56) and 1.8%(1/56) separately, the difference was statistically significant. No major bleeding complication occurred in therapy group.
    Conclusion The probability of CVC-related DVT was significantly higher than that of the control group, the incidence can be reduced by prophylactic anticoagulant therapy with subcutaneous low-molecular-weight-heparin.
    Retrospectively Case Study of 19 Patients with Pneumocystis Pneumonia
    QIAO Jian-qin;TONG Zhao-hui;YIN Yu-dong;WANG Zhen;CAO Bin;WANG Ya-jie;GONG Juan-ni
    2010, 31(5):  552-557. 
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    Objective To study the clinical characteristics, diagnosis and treatment of Pneumocystis carini pneumonia(PCP). Methods The retrospective analyses of 19 inpatients who were diagnosed with PCP in Beijing Chaoyang Hospital from 2004 to 2008 were performed, and the literature was reviewed with regard to clinical profiles. Results Of the19 PCP patients, 12 were male and 7 female. The average age was(41.53±9.22) years. Five patients(26.3%) were co-infected with human immunodeficiency virus(HIV). The remaining 14 non-HIV-infected patients had underlying diseases. Seven patients had a sudden onset; others had a gradual onset. Twelve of 19 patients had normal or mildly coarse breath sounds on auscultation; 5/19 patients had rales at the bottom of lung. 2/17 of the patients had inspiratory crackles which is considered to be related with fibrosis of lung. The most common abnormal chest radiological findings were bilateral diffuse interstitial infiltrations, patchy shadows or ground-glass. Seven patients were found positive for PC in their sputum or bronchoalveolar lavage fluid(BALF) by Gomori methenamine silver stain(GMS), 7 patients were proved positive for PC in their sputum or bronchoalveolar lavage fluid by polymerase chain reaction(PCR ), and one patient was also proved positive for PC in transbronchial lung biopsy(TBLB). All patients were treated with trimethoprim-sulfamethoxazole and 84.2%(16/19) of the patients were treated with corticosteroids concomitantly. Five patients died; 3 of 5 patients succumbed to MODS, 2 succumbed to ARDS. Overall crude mortality was 26.3%. Conclusion Being infected with HIV much frequently and increasing immuno-suppressive therapy(such as organ transplantations and tumor therapy), PCP does not belong to rare diseases. The mortality of PCP was high despite appropriate treatment, because of lack of specific clinical characteristics. Chemoprophylaxis should be considered in populations at high risks.
    Single Nucleotide Polymorphisms in Fibrinogen Coding Sequence and Thrombotic Diseases
    LI Ji-feng;WANG Chen;WANG Jun
    2010, 31(5):  558-562. 
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    As the most abundant component of coagulation system, fibrinogen not only takes part in clotting, but also works as one of acute phase proteins. Fibrinogen participates in many physiological and pathophysiological processes through modulating blood viscosity, endothelial function and promotion of smooth muscle cell proliferation and migration. It has been found that there are positive associations between the abnormal structure or function of fibrinogen induced by single nucleotide polymorphisms(SNP) in fibrinogen coding sequences and many kinds of diseases, especially thrombotic disorders. This review summarized the SNP in fibrinogen coding sequences and its relationship with diseases.

    慢性乙肝临床转归个体化治疗预测模型研究
    Two year Efficacy of Entecavir for the Treatment of Chronic Hepatitis B, Compensated and Decompensated Cirrhosis
    YOU Hong;WU Xiao-ning;WANG Qian-yi;WU Peng;CONG Rui;YANG Ai-ting;OU Xiao-juan;MA Hong;ZHANG Fu-kui;WANG Bao-en;JIA Ji-dong
    2010, 31(5):  563-565. 
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    Objective To compare antiviral effects of entecavir in patients with chronic hepatitis B, compensated and decompensated cirrhosis patients after 2 years of treatment with entecavir. Methods Totally 63 treatment-na-ve patients with chronic hepatitis B(41 cases), compensated(15 cases) and decompensated cirrhosis(7 cases) patients were treated with entecavir 0.5 mg once daily. Alanine aminotransferase(ALT) and HBV DNA were detected and analyzed at three-month interval. Results The baseline characteristics of the three groups were comparable by age, gender, ALT and HBV DNA. There was no significant difference in ALT normalization and HBeAg seroconversion rate after oneyear and twoyear entecavir treatment. The 2-year HBV DNA undetectable(<5×105 IU/mL) rate and median reductions were 81.8% and 5.4 lg in chronic hepatitis B, 83.3% and 6.0 lg in compensated cirrhosis, 88.1% and 5.8 lg in decompensated cirrhosis. The kinetics of HBV DNA suppression at every 3 months interval were similar among three groups. Conclusion There was no significant difference efficacy of after 2 years of treatment with entecavir in patients with chronic hepatitis B, compensated and decompensated cirrhosis patients.
    Pilot Study on the Adefovir Dipivoxil Monotherapy in Telbivudine Resistant Patients with Chronic Hepatitis B
    REN Jiang-bo;WANG Yu;LI Hong-yi;SUN Shu-jie;MA Hong;JIA Ji-dong
    2010, 31(5):  566-569. 
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    Objective Adefovir dipivoxil(ADV) is effective in treatment of lamivudine(LAM)resistant chronic hepatitis B(CHB). However, the effect of ADV monotherapy on telbivudine(LdT)resistant CHB needs to be elucidated. The aim of this study was to observe the efficacy and resistance of ADV monotherapy in LdT-resistant patients. Methods Thirteen LDT-resistant CHB patients(10 HBeAg positive patients and 3 HBeAg negative patients) were treated with 10 mg ADV once daily at least 48 weeks, follow-up was performed every 12 weeks and virological, serological and biochemical responses were explored. Virological response was defined as HBV DNA <300 copies/mL. Results The baseline median HBV DNA was 3.9×109 copies/mL. Viral load was decreased 3.77, 4.28 and 5.31 lg copies/mL at 12, 24 and 48 weeks and dropped persistently with the therapy continuation. Biochemical response(ALT) was obtained after virological response. There was no serological response and ADV resistance after 96 week treatment with ADV. Conclusion Switching to ADV monotherapy in LdT-resistant patients with CHB can reduce HBV DNA rapidly and effectively. No ADV resistance was found during up to 96 weeks treatment.
    Four-year Efficacy and Safety of Adefovir Dipivoxil for the Treatment of Chronic Hepatitis B
    OU Xiao-juan;WANG Xiao-ming;YOU Hong;JIA Ji-dong;WANG Yu;DUAN Wei-jia;LI Yi-mei;LI Jia;WANG Bao-en
    2010, 31(5):  570-572. 
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    Objective To assess the long-term efficacy and safety of generic adefovir dipivoxil(ADV) for the treatment of Chinese patients with chronic hepatitis B. Methods<'b> This four-year random, double-blind, controlled study included 240 patients with chronic hepatitis B virus(HBV) infection, 120 received ADV monotherapy. Alanine aminotransferase(ALT) normalization, HBV DNA loss and safety were evaluated every 6 months. Results ALT normalization rate was significantly higher in the ADV group than that in the control group. After 1 year ADV treatment the ALT normalization rate was 76.8% and sustained at 58% for the following 3 years. Complete virological response(HBV DNA<500 IU/L) was observed in 48.3%, 38.3%, 44.2% and 43.3% of the cases during the four years of ADV treatment respectively. The safety profiles showed no significant difference between the ADV and control group, except that only 4 patients had slightly increased(less than 0.5 fold higher than baseline level) creatinine. Conclusion Generic ADV showed the good anti-HBV efficacy and safety during the four years treatment.
    Follow up Study of HBV-induced Decompensated Cirrhosis Treated with Nucleot(s)ide Analogues
    YANG Ye;CHEN Jing-shou;OU Xiao-juan;JIA Ji-dong;YOU Hong
    2010, 31(5):  573-577. 
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    Objective To observes the efficacy of the four nucleot(s)ide analogues including lamivudine, adefovir, entecavir and telbivudine in treatment of HBV-induced decompensated cirrhosis. Methods Patients with HBV-induced decompensated hepatitis B cirrhosis treated with and without nucleot(s)ide analogues(NAs) were followed up for a median of 11 months. HBV DNA, liver function, Child-Pugh-Turcotte scores, and MELD scores. Results A total of 52 patients were enrolled in this study after excluding 59 patients out of 111 patients with HBV-induced decompensated hepatitis B cirrhosis. Forty patients were assigned into the NAs group and 12 patients into the control group. In the control group, the HBV DNA, ALT, AST, ALB, TBIL, CHE, INR, Child-Pugh scores and MELD scores had no improvement between as compared with the baseline values and the end-of-follow up values. In the NAs group, the HBV DNA, ALT, ALB, CHE, INR, Child-Pugh scores had significant improvement(P<0.05) and AST, TBIL, MELD scores had no improvement(P>0.05). Conclusion Nucleot(s)ide analogues could suppress HBV replication, improve liver function,stabilize or even reverse the development of decompensated cirrhosis and be welltolerated. Further studies are needed to observe the longterm efficacy and the rate of liver cancer development.

    The Construction and Test of Clinical Web Information System and Sample Management System of Chronic Hepatitis B
    WU Xiao-ning;YOU Hong;WU Jin-zhao;WU Peng;CONG Rui;WANG Mei-juan;MA Jia-li;WANG Rui;OU Xiao-juan;JIA Ji-dong
    2010, 31(5):  578-581. 
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    Chronic hepatitis B is an important public health issue in China, it has great meanings to establish a large and standardized information bank for clinical research. We have constructed and tested performance of a clinical web information system and sample management system of chronic hepatitis B in our hospital, and here we introduce both the systems.
    Natural History and Long-term Outcome of Chronic Hepatitis B Virus Infection
    WANG Hui;JIA Ji-dong
    2010, 31(5):  582-585. 
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    Chronic hepatitis B virus(HBV) infection is a state of interactions among HBV, the hepatocytes and the immune system of the patient. The natural course of chronic HBV infection is now thought as comprising 3 phases: immune tolerance, immune clearance\[HBeAg-positive chronic hepatitis\], carrier state, and now HBeAg-negative chronic hepatitis B is also considered as a particular phase. Understanding the natural history of chronic HBV infection is crucial in the management of HBV infected patients and underscores the need for long-term monitoring. Accumulating evidence indicates that antiviral therapy can prevent progression of HBV-related liver disease, particularly among patients with sustained response. Pegylated interferon(IFN) and newer nucleos(t)ide analogues may have even better long-term outcomes because of better therapeutic efficacy and/or a low risk of drug resistances. The treatment outcomes are still far from satisfactory. The development of safe and affordable anti-HBV agents or strategies is needed to further improve outcomes.
    Evaluation of Middle Cerebral Artery Occlusion Induced Focal Cerebral Ischemia Model in Mice
    YU Pei-lan;SUI Lei-ming;HAN Song;ZHAO Huan-ying;JIANG Jun;LI Jun-fa
    2010, 31(5):  586-590. 
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    Objective To study the success rate and reliability of middle cerebral artery occlusion(MCAO) model by objective and reliable neurological score, infarct volume, and edema rate. Methods Cerebral ischemia model of MCAO was established in mouse using the suture method. Infarct volume, edema rate and behavioral performance was evaluated by 2,3,5-triphenyltetrazolium chloride(TTC) staining and neurological score. Results MCAO could induce obvious focal cerebral ischemia by TTC staining and the success rate of this model was about 90.8%. Besides, MCAO could induce three types of cerebral ischemia: cortical, hippocampal and thalamic ischemia. And the predominant type is cortical ischemia. MCAO-induced cerebral ischemia could significantly increase the neurological score compared with the sham group. The procedure for infarct volume evaluation of the MCAO model was accurate and stable; infarct volume was about 35% of entire brain volume. Conclusion Cerebral ischemia model of MCAO was established in mice successfully(90.8%). The evaluation of neurological deficit and infarct volume was technically reliable.

    Effects of Different Culture Conditions on Output of Excretory-secretory Antigens Produced by Tichinella spiralis Muscle Larvae
    CUI Shi-juan;YANG Jing;GU Yuan;WEI Jun-fei;WANG Shao-hua;YANG Ya-ping;ZHU Xin-ping
    2010, 31(5):  591-595. 
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    Objective In order to get a better protocol of excretory-secretory(ES) antigen preparation, the yield products and components of Trichinella spiralis muscle larvae antigens in conventional RPMI 1640 tissue culture medium and in other host mimic culture media, and the temporal appearance of ES antigen-specific antibodies in the early stage of infection in mice were analyzed. Methods Culture media was divided into different groups according to different combination of ultrafiltrated mouse sera, reduced glutathione and bile powder. Under the same conditions such as worm number, volume of culture media, incubation time and temperature, concentration of ES antigen solution etc, ES antigens in different culture media were prepared and collected separately. SDSPAGE was performed with ES products of all groups with the same loading volume. The gel was scanned with Odyssey infrared laser image system, and the signal intensity of the major bands was detected to perform quantitative comparison; the activity and variety of ES antigens in different groups were detected by Western blotting. Western blotting was also performed with sera of mice infected with different time points(15, 18, 20, 21, 22, 24, 27, 30, 40, 50 days postinfection) to determine the temporal appearance of ES antigenspecific antibodies. Results Quantitative analysis of SDS-PAGE gel showed that the antigen yield of group ultrafiltrated mouse sera plus reduced glutathione, bile powder and ultrafiltrated mouse sera plus bile powder groups, were much higher than that of RPMI 1640 group. The ultrafiltrated mouse sera plus bile powder group had the best yield. Western blotting showed that ES antigens of all groups could be recognized by infected mouse sera(40 days postinfection), the fluorescent signal of a band with the probable molecular weight 87000 of ultrafiltrated mouse sera plus reduced glutathione group was evidently stronger than the other groups; Western blotting also showed that in the major components of ES antigens, the proteins molecular weight if 45 000, 53 000, 41 000 induced specific antibodies one after another. The earliest antibodies were detected with mouse sera of 15, 21 and 24 days postinfection respectively. Conclusion Yield of T. spiralis muscle larvae ES antigens with good activity could be highly increased by adding bile powder into culture media. Moreover adding bile powder and ultrafiltrated mouse sera together into culture media could further increase the yield. In the early stage of infection different components of ES antigens induced predominant specific antibodies asynchronously. These might ameliorate the protocol of ES antigen preparation and provide experimental evidence for searching early diagnostic antigens of trichinellosis.

    The Relationship between Cardiac Hypertrophy Index and Cardiac Function in Chronic Heart Failure Rats
    MA Li;LIU Jie;CHU Nan;YANG Jin-gang;SHI Xu-bo;WANG Ya-jie;LI Tian-chang;HU Da-yi
    2010, 31(5):  596-599. 
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    Objective To establish rat model of chronic heart failure by partially banding abdominal aorta for different time limits and to compare the effects of different index on the evaluation of cardiac hypertrophy and heart function. Methods Eighty Wistar rats were randomly divided into two groups: aortic banding group and sham-operated group(each containing 40 rats). Brain natriuretic peptide(BNP) concentration and cardiac hypertrophic changes were investigated in different groups. Results Cardiac myocardial diameter(CMD), type I collegen concentration and BNP concentration increased from 4 weeks after aortic banding(P<0.05) compared with sham-operated group. Eight weeks after the operation, -dp/dt decreased. LVSP increased from 12 weeks after the operation, and +dp/dt decreased at the same time. Changes above became more significant 16 weeks after the operation. There was a good correlation between BNP concentration and hemodynamic and hypertrophic parameters. Conclusion In the rat model of chronic heart failure by partially banding abdominal aorta, the changes of hypertrophic index emerge before the cardiac function changes.

    Changes of Extracellular Amino Acids Levels in Related Brain Regions after High Frequency Electrical Stimulation of Nucleus Accumbens in Morphine Psychic Dependent Rats
    HU Wen-han;ZHANG Ying;MENG Fan-gang;ZHANG Bin;ZHANG Kai;ZHANG Jian-guo
    2010, 31(5):  600-603. 
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    Objective To investigate the changes of levels of glutamate(Glu) and gammaaminobutyric acid(GABA) in nucleus accumbens(NAc), ventral pallidum(VP) and ventral tegmental area(VTA) after high frequency electrical stimulation of NAc in morphine psychic dependent rats, and illustrate the mechanism of high frequency electrical stimulation treatment of drug psychic dependence. Methods Morphine hydrochloride was injected subcutaneously in Wistar rats for 10 days(3 times per day), sodium chloride solution was injected subcutaneously in rats of control group. At the 7th day after withdrawal of morphine, Concentric bipolar electrodes were stereotaxically implanted into the NAc and microdialysis probes were unilaterally placed into NAc, VP and VTA of rats after anesthesia, the microdialysates before stimulation and after stimulation were collected. The levels of extracellular Glu and GABA in microdialysates were determined by high-performance liquid chromatography(HPLC). In control group, only stimulating electrodes were implanted, stimulation was not proceeded.Results The levels of extracellular Glu in NAc increased in morphine group. During and after stimulation of NAc, the levels of extracellular Glu in NAc and VTA decreased, but the levels of extracellular GABA did not change; The levels of extracellular Glu and GABA in VP did not change. Conclusion Glu is an important factor to maintain psychic dependence, and high frequency electrical stimulation can induce decrease in extracellular Glu levels in NAc and VTA to diminish morphine psychic dependence.

    Effects of Different Substrata on Explant Culture of Rabbit Tracheal Epithelium Ciliated Cells
    WANG Hong;ZHANG Wei;JIAO Jian;JIN Shan-zhe;ZHANG Luo;
    2010, 31(5):  604-609. 
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    Objective To compare the effects of four substrata in cell culture of rabbit tracheal epithelium ciliated cells and to explore the more suitable substratum for the cell model established in vitro. Methods Self-made rat tail collagen, commercial rat tail collagen, poly-L-lysine and gelatin were coated on glass coverslip respectively for explants culture of rabbit tracheal mucosal specimens.Results The anchorage rates of rabbit tracheal mucosal specimens on the four substrata respectively are: selfmade rat tail collagen 89.1%, commercial rat tail collagen 43.5%, poly-L-lysine 36.9% and gelatin 21.7%. The maximal monolayer radius of anchorage tissues on four substrata respectively are: selfmade rat tail collagen(1 432.2±383.2)μm, commercial rat tail collagen(928.9±390.3)μm, poly-L-lysine(889±229.2)μm and gelatin(651±221.2)μm. The maximal ciliary beat frequency and duration respectively are: self-made rat tail collagen(10.0±1.5)Hz 11 days, commercial rat tail collagen(8.5±0.6)Hz 5 days, poly-L-lysine(8.9±0.5)Hz 3 days and gelatin(5.9±0.3)Hz 2 days. Under the electron microscope, self-made rat tail collagen fibers show a reticulate pattern, which may play an active role in ciliary cell anchorage and growth. Conclusion Our study indicates that self-made rat tail collagen is the most suitable substratum among the four in explants culture of rabbit tracheal epithelium ciliated cells in vitro and could be a reliable cellattracting substance for ciliary function study.

    Expression of Sphingosine 1 phosphate Receptors in Fibrotic Liver Induced by Carbon Tetrachloride
    YANG Lin;ZHAO Dong-xu;LI Li-ying
    2010, 31(5):  610-613. 
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    Objective To determine the mRNA and protein expression of sphingosine 1-phosphate receptors 1, 2 and 3(S1P1-3) in the normal and fibrotic liver. Methods ICR mice were randomized into two experimental groups, control [olive oil(OO) treated] and model(CCl4 treated) groups. Mice were sacrificed at two or four weeks of treatment. Liver tissue was examined by real-time RT-PCR and Western blotting to analyze the expression of S1P1-3. Results Two or four weeks treatment by CCl4, S1P1 mRNA expression was not significantly different; S1P2, S1P3 mRNA expression was up-regulated(P<0.05) in liver tissue. Correspondingly, S1P1 protein level was not significantly different; S1P2, S1P3 protein level was up-regulated(P<0.05). Conclusion During the process of liver fibrosis, sphingosine 1-phosphate receptor1-3 mRNA expression and protein level were various, the relative mRNA and protein level expression of S1P2, S1P3 have shown increases. Our results indicate that S1P receptors have an extremely important role in liver fibrogenesis.

    Discovery of Lead Pseudopeptides for Drug Design
    XU Yan-xia;ZHAO Ming;WANG Yu-ji;WU Jian-hui;LI Li;ZHANG Jian-wei;KANG Gui-feng;PENG Shi-qi
    2010, 31(5):  614-622. 
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    The discovery of lead compounds is a key step to drug design. Pseudopeptide is one of the most important lead structures. Various pseudopeptides could be prepared based on either the structures or the mechanisms of action. For the design of the anti-thrombotic, thrombolytic, anti-tumor, anti-osteoporosis and lead detoxification drugs, in the past years we published numerous reports on pseudopeptides of alkaloid-peptides, heterocyclics-peptides, steroid-peptides, saccharide-amino acids and so on. This paper reviews the pharmacological benefits of some pseudopeptides of our laboratory.

    Changes in mRNA Expression of Peroxisome Proliferator-activated Receptor-γ Co-activator 1(PGC-1α) in Different Tissues of OLETF Rats
    WU Yi-ming;CHEN Cheng;ZHANG Jun-qing
    2010, 31(5):  623-627. 
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    Objective Peroxisome proliferator-activated receptor-γ co-activator 1(PGC-1α) is an important nuclear receptor co-activator, which was involved in regulating glycogenolysis, gluconeogenesis and the glucose utilization of the surrounding tissue. It also plays an important role in maintaining the balance of body energy metabolism, glucose and lipid metabolism. Our study was designed to explore the role of PGC-1α in the diabetes and insulin resistance by observing the changes of the PGC-1α mRNA in the liver, skeletal muscle, fat and pancreatic tissues of OLETF rats. Methods ① OLETF and LETO rats were fed with high sugar(10%) at the 8th week, and OLETF rats all became diabeties in the 18th week. ② Four rats of each group were sacrificed in the 8th and 28th week. Liver, skeletal muscle, fat and pancreatic tissues were collected and total RNA were extracted. PGC-1α mRNA expressions was analyzed by using real-time quantitative PCR. Results ① Body weight and TG level of OLETF rats increased with weeks of age dependent and were significant higher than those of same age of LETO rats from 14th week. After fasting and glucose loading, insulin levels of OLETF rats were also significant higher than that of the same age of LETO rats starting from 22nd week. ② At the 8th week, there were no significant difference in PGC-1αmRNA expression between OLETF and LETO rats in the liver, skeletal muscle, fat and pancreatic tissue. ③ At the 28th week, compared with the LETO rats, the PGC-1αmRNA expression of OLETF rats decreased significantly in the liver(0.040±0.006 vs 0.074±0.003, P=0.029) and pancreas(0.659±0.299 vs 1.610±0.091, P=0.029), but increased significantly in skeletal muscle tissues(0.192±0.065 vs 0.104±0.012, P=0.029). It also showed a downward trend in the adipose tissue(0.055±0.036 vs 0.161±0.124, P=0.100).
    Conclusion OLETF rat showed insulin resistance and hyperglycemia, a typical pathological feature of early stage of type 2 diabetes at 28th week. The changes of PGC-1α mRNA expression in the liver, skeletal muscle, fat and pancreas of OLETF rat might be a compensatory response in the insulin resistance and hyperglycemia state of early stage of diabetes. It suggested that the changes of PGC-1α expression in the different tissues may be involved in the pathogenesis of insulin resistance and diabetes.

    Separation and Purification of Total Polyphenols from Acer truncatum Bunge Leaves with Macroporous Adsorption Resin
    YE Yan-bin;LI Xi-xuan;GAO Wen;FAN Yuan-jie;YANG Hua;ZHANG Feng;ZHANG Ying-xia
    2010, 31(5):  628-632. 
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    Objective To study the optimal techniques for separation of total polyphenols from the leaves of Acer truncatum bunge with macroporous adsorption resins.Methods The static and dynamic adsorption-desorption characteristics were taken as index to select the macroporous adsorption resin. The separating efficiency was evaluated by measuring the concentration of total polyphenols in A. truncatum. with UV spectrophotometer.Results The HPD100 macroporous adsorption resin had the best separating efficiency. The optimum separation conditions of macroporous adsorption resin HPD100 are as follows: the concentration of the extract from A. truncatum. leaves solution is 5 mg/mL, and the velocity is 2 mL/min, with 4BV of 70% ethanol to elute. Conclusion The total polyphenols in the leaves of A. truncatum was able to be easily separated and purified by HPD100 resin, and its adsorption-desorption characteristics were stable under the optimum conditions mentioned above. The original content of polyphenols was 28.55%, after purification with HPD100, it could reach 39.52%.

    Investigation on Psychological Burden of Undergraduates in School of Public Health & Family Medicine Capital Medical University
    LI Zhen;YANG Lin;ZHANG Man;ZHU Yong-ji;LIANG Jing;HUO Da;WU Wei
    2010, 31(5):  633-637. 
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    Objective To investigate the psychological status of undergraduates in School of Public Health and Family Medicine, Capital Medical University and to take measures to lower the psychological burdens and reduce the negative outcomes. Methods Based on relevant literatures and investigations, a self-designed questionnaire was used to survey all 205 undergraduates(The investigating rate was 83.7%, the collecting rate is 91.1%). The questionnaire was answered by students at spare time in the anonymous, selfadministered way. Their psychological burden was leveled as none, little, strong, and extreme. The Data were analyzed by Chi-square test, Wilcoxon signed rank test and correlation analysis. Results Among all the objects, 8.8% of students felt no pressure, 65.4% felt a little, 19.0% felt more and 4.8% felt too high a pressure. The data showed that pressure from academic achievement and job searching was the most common sources referred to. Facing the pressure, 39.5% and 20.5% of students treated it by talking with friends and family members respectively, and 20% chose to manage it by themselves. In response to the pressures, most students prefer defocusing or self-adjustment. Conclusion The level of pressure in the undergraduates is normal. But various activities and psychological education are still needed for students to make their school life smooth.

    Analysis on Epidemiology of Varicella in 2006~2009 in Beijing Shunyi District
    FENG Ran;LI Yin-dong;LI Chang-qing;ZHANG Song-jian;WANG Feng-shuang;WU Dan;XIAO Lei
    2010, 31(5):  638-641. 
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    Objective To understand the epidemiologic characteristics and trends of varicella in Beijing Shunyi district, so as to provide scientific evidences for formulating the prevention and control strategies for varicella. Methods The methods of descriptive epidemiology were used to analyze the surveillance data on varicella from 2006 to 2009 in Beijing Shunyi district. Results A total of 3 346 cases of varicella were reported during the period,among them there were 760 cases in 2006, 745 cases in 2007, 948 cases in 2008 and 893 cases in 2009. The incidence rate of varicella was 100.00/100 000 in 2006, 95.88/100 000 in 2007, 122.00/100 000 in 2008 and 114.92/100 000 in 2009. Distribution of varicella cases were mainly in Shunyi's urban district where the population density is high. The male and female ratio of varicella patients was 1.27∶1. Almost all the outbreaks of varicella happened in kindergarten and primary and secondary schools. There was a significant seasonal change that winter and spring are the two seasonal peaks of varicella. Meanwhile, there were 6 sudden epidemics of varicella and 23 outbreaks of it, which accounted for more than 70% of all the outbreaks and sudden epidemics in Shunyi district. Conclusion Varicella vaccine has been incorporated into national immunization program in the premise of the effective varicella vaccine; great importance has been attached to varicella in school and other crowded places; It is important to increase publicity to improve people's awareness of knowledge about varicella.

    Research for the Reference Ranges of Five Essential Elements in the Serum of Healthy People between 17 and 30 Years of Age in Beijing
    YU Hui-yan;BI Xiao-yu;ZHAO Rui;QI Na
    2010, 31(5):  642-644. 
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    Objective Reference ranges of levels of five essential elements (copper, zinc, iron, calcium and magnesium) in serum of 300 healthy people between 17 and 30 years of age in Beijing were studied to provide useful data for the clinical diagnosis.Methods Based on the method of atomic absorption spectrometry, the authors tested the contents of the five elements in serum, and calculated the distribution differences of these five elements with sex and age. Results The distribution of the contents of these elements was Gaussian distribution. The levels of iron and calcium in serums between male and female had a significant difference(P<0.05), and the level of calcium in serum had a significant difference(P<0.01). Conclusion The content of iron in serum of male was higher than that of the female healthy adults in Beijing. On the contrary, the content of calcium of female was higher than that of the male. The content of calcium in serum decreased with aging.

    Clinical Observation on Hard Exudates in the Macular Area in Nonproliferative Diabetic Retinopathy
    ZHOU Hai-ying;JIAO Xuan;ZHAO Meng;GONG Jin;MAO Yu;PENG Xiao-yan
    2010, 31(5):  645-648. 
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    Objective To characterize the clinical features of the hard exudates within the macular area in nonproliferative diabetic retinopathy. Methods A retrospective hospital-based cross-section study was conducted. 261 patients(440 eyes) who were diagnosed as nonproliferative diabetic retinopathy in one or both eyes by fundus fluorescein angiography(FFA) were enrolled in this study. The extension and severity of hard exudate within the macular area were graded from the fundus photograph and collected. The relationship between hard exudates and visual acuity were also analyzed. Results There were 440 eyes diagnosed as background diabetic retinopathy(BDR) Ⅱ and Ⅲ. Among them, 152 eyes(34.6%) had no macular involvement by hard exudates, but 272 eyes(61.8%) had hard exudates involving macular area. sixteen eyes(3.6%) could not be graded because of media haze. Hard exudates were mainly situated in the temporal side of the macula and often involved one or two quadrants of macular area. Eyes without hard exudates involving 500 μm of the center of the macula were 63.9% out of 440 and 50.6% had visual acuity beyond 0.5. Eye with mild macular involvment were 27.6% out of 440 and 42.6% had visual acuity beyond 0.5. Eyes with heavily involved macula were 4% out of 440 and 22.9% had visual acuity beyond 0.5(P=0.02). 88% patients had severe hard exudates in one eye and mild hard exudates in the other. There was significant difference in severity of hard exudates between two eyes(P<0.0001). Conclusion Retinal hard exudate is a common retinal lesion of the nonproliferative diabetic retinopathy. The hard exudates is often located at the temporal side of macula. The extention asymmetry of hard exudates is common while severe hard exudates is rare. The location and severity of retinal hard exudates are directly related to the decrease of visual acuity.

    Study for the Biocompatibility of Decellularized Vascular Scaffold
    DONG Jian-de;ZHANG Jian;GU Yong-quan;HUANG Jin-hong;GAO Feng;LI Chun-min
    2010, 31(5):  649-652. 
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    Objective To evaluate the biocompatibility of decellularized vascular scaffold prepared with Triton X-100 and trypsin. Methods In vitro and in vivo tests were performed to evaluate the biocompatibility of the decellularized vascular scaffold. The in vitro tests included directcontact method and MTT assay, and the in vivo test was subcutaneous implant test.
    Results L929 cells grew well on the glass slide covered with decellularized vascular scaffold and in the solution of decellularized vascular matrix. The patches implanted subcutaneously in SD mice only caused slight inflammatory reaction after 2 weeks. Conclusion Decellularized vascular matrices prepared with Triton X-100 and trypsin had a good biocompatibility.

    The Surgical Skill and Outcome of Extended Resection of Frontopolar Glioma
    LU Zheng;LIAO Hao;XIE Jian
    2010, 31(5):  653-656. 
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    Objective To evaluate the surgical skill and outcome of extended resection of frontopolar glioma. Methods From April 2005 to May 2009, extended resection was performed in 34 patients with frontopolar glioma. Within 2 cm limit around the “border” of the tumor, the tumors were totally removed with involved brain tissue. The resection margin was defined by anatomic landmarks such as longitudinal fissure, lateral fissure, coronal suture, corpus callosum, frontal horn of the lateral ventricle, optic nerve and optic chiasm. Radiation therapy was given postoperatively. Results In our series,there was no operative death. No severe complications occurred. The pathological results were 10 low-grade and 24 high-grade glioma. Clinical remission obtained in all patients with headache and 94.4%(17/18) patients had epilepsy. The mean time of followup was 22 months(9~46 months). There was no recurrence in patients with lowgrade glioma(n=24, KPS 80~100). 6 recurrences were noted in patients with highgrade glioma(n=10). A patient with glioblastoma died of tumor recurrence 17 months after the surgery. Two patients with anaplastic oligoastrocytoma died of tumor recurrence 20 and 36 months after the surgery respectively. KPS was 50~100 in survivors. Conclusion The anatomic landmarks can be used in extended resection of frontopolar glioma. The surgical procedure is safe and reliable. On the premise of preservation of vital functions, the extended resection may prolong life.

    Relationship of Estrogen Receptor β Gene Polymorphisms with Leiomyoma of the Uterus in Han Population
    WANG Jia-yin;ZHANG Hai-zhen;GUAN Yun-qian;XIE Feng
    2010, 31(5):  660-663. 
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    Objective The present study was designed to investigate the possible association between estrogen receptor(ER) β gene polymorphisms and leiomyoma in a Chinese(Han) population. Methods The distribution of the ERβ gene polymorphisms were examined in 285 Chinese(Han) females: 92 patients and 193 healthy controls. Genomic DNA was obtained from whole blood. ERβ gene polymorphisms were assessed by the method of polymerase chain reactionrestriction fragment-length polymorphism(PCR-RFLP). Results No significant differences between the leiomyoma patients and the controls in the frequencies of the polymorphisms in the ERβ gene were found in the subjects. Conclusion The RsaI and AluI polymorphisms of the ERβ gene were not associated with the establishment of leiomyoma of the uterus in the Chinese(Han) population.

    Use of Bispectral Index(BIS) Monitor in Inspecting the Depth of Anesthesia in Pediatric Patients Undergoing General Anesthesia
    ZHANG Jian-min;WANG Fang;LV Hong;XIN Zhong
    2010, 31(5):  664-667. 
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    Objective To investigate the feasibility of using bispectral index(BIS) monitor to inspect anesthesia depth in pediatric patients. Methods Forty pediatric patients(American Society of Anesthesiologists(ASA) Ⅰ-or Ⅱ) undergoing general anesthesia, tracheal intubation and elective surgery were recruited. Anesthesia was induced by the intravenous injection with propofol/remifentanil; maintained by the intravenous infusion with propofol/remifentanil. Patients were classified by age into four groups(10 in each): A(≤3 mo), B(>3 mo to 2 yr), C(>2 yr to 6 yr), and D(>6 yr to 12 yr). Sedation was assessed by the University of Michigan Sedation Scale(UMSS), and BIS value was recorded before the induction(T1), after the induction(T2), at tracheal intubation(T3), at skin incision(T4), at discontinuation of intravenous propofol/remifentanil(T5), at the evidence of spontaneous respiration(T6) and at tracheal extubation(T7). Postanesthesia spontaneous respiration recovery time(from T5 to T6) and postanesthesia extubation time(from T5 to T7) were recorded. Results (1) UMSS scores were 0~1 at T1, increased since T2, 4 at T4, decreased to 0~1 at T7 as seen at T1, in a group. Correspondingly, (2) BIS values were above 96% at T1; decreased since T2(P<0.01); increased to the level of T1 at T7, in a group. (3) Average postanesthesia extubation time was longer(P<0.01) in group A than those in groups B, C or D. (4) Average post-anesthesia spontaneous respiration recovery times were not significantly different between any pair of two groups. Conclusion BIS is an indicator of anesthesia depth in pediatric patients undergoing general anesthesia by the propofol/reminfentanil program.

    综述
    Role of Chemokines in the Pathogenesis of Psoriasis
    ZHANG Yan-li;JIA Hong-xia;HE Yan-ling
    2010, 31(5):  673-677. 
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    Psoriasis is an immune-mediated chronic inflammatory skin disease, a variety of cells and cytokines play a dominant role at different stages, inflammatory cells infiltration in the skin and release various cytokines at the onset of and during the course of disease. The chemokine family is characterized by their ability to induce directional migration and activation of leukocytes and non-hematopoietic cells, including endothelial cells to inflammatory sites. Many chemokines may play an important role in the pathogenesis of psoriasis, for example, CCL17 and CCL27 are very important for T-cell tissue homing;CCL2 and CXCL8 are also involved in keratinocyte proliferation and neovascularization. A single nucleotide polymorphisms of the CCL2 and CX3CR1 are associated with psoriasis.
    诺贝尔奖
    In Vitro Fertilization and Test Tube BabyIntroduction of Nobel Prize in Physiology or Medicine 2010
    ZHANG Ting;WANG Xiao-min
    2010, 31(5):  678-682. 
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    Robert Edwards is awarded the 2010 Nobel Prize for the development of human in vitro fertilization(IVF) therapy. On 25 July, 1978, the world’s first “test tube baby” was born, and today close to 4 million babies have been born thanks to the discovery of human IVF. Children born after IVF are in general as healthy as children born after natural conception according to several long-term follow-up studies. Though Edwards’ work raised many ethical problems, it is indisputable that his achievement made it possible to treat infertility, a medical condition afflicting a large proportion of humanity including more than 10% of all couples worldwide.